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What is an elective single embryo transfer?

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6 fertility expert(s) answered this question

Answer from: Saghar Kasiri, Clinical Embryologist

Embryologist, Director of European Operations Cryos International
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Elective single embryo transfer is where you have a pool of embryos available, where only one embryo, the best one perhaps, is picked to be transferred for you for the fresh cycle that you’re having and the remaining embryos are then frozen and kept in the storage for you. The reason in the last few years, we have all been trying to move towards having one embryo transfer these. We have seen that multi multiple pregnancies carry a huge risk to the mother and to the children so, it is likely we see higher miscarriages rates when we have twin or triplet pregnancies and therefore it’s been by some countries by the regulators that has put a particular percentage on how many multiple pregnancies we can have and therefore moving the clinics towards single embryo transfer or it has been the science and the data that has been proving that cumulative pregnancy rate is usually better when you do one transfer of the embryo in each either fresh cycle or the consecutive frozen embryo transfer cycle. Your chances of pregnancy are very much similar to consecutive cycles where you only have one embryo transfer than to have two or three embryos to put back and then have the risk of losing all of them or one or two of them during the pregnancy.

Answer from: Andrew Thomson, FRCPath

Embryologist, Consultant Clinical Embryologist & Laboratory Manager Centre for Reproduction and Gynaecology Wales (CRGW)
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An elective single embryo transfer is the best way to get you pregnant. It doesn’t apply to everyone but the best thing in our experience to do, is to culture everything through to a blastocyst stage and say, for example, you have four blastocysts to elect and to put a single embryo back in your first transfer and freeze the other three and then electively choose to put another one back in a frozen and then another one and then another one. Your chances of pregnancy across the four transfers will be higher than it would be if you were to have a double embryo transfer and a double embryo transfer because you there’s too many different variables within the endometrium, within the embryo development. Giving you four different attempts is always going to be better than giving you two attempts, so the elective part is opting – you’re making that informed choice to have a single embryo back and personally I’m very much elected single embryo transfer and it also minimizes that risk of a multiple pregnancy. It still happens- that’s identical twins but you’re minimizing that risk and then by not having a twin pregnancy,  you’re not at higher risk of miscarriage or premature birth or low birth weight and all the things that are associated with twin pregnancy.

Answer from: Yacoub Khalaf, Professor

Gynaecologist, Professor of Reproductive Medicine and Surgery at King’s College
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Plenty of embers we choose one of them to put back and that aims to reduce multiple births and multiple births sounds like a very good bargain – two for the price of one or three for the price of one but when it comes to health outcomes, it is disastrous because 10% of twins will deliver before 32 weeks with the potential of them spending some time in the neonatal intensive care unit (attached to lots of wiring and having lots of injection and feeding and all of that with the potential for physical and mental handicap). If that was to happen to be three babies instead of one, the chance of having cerebral palsy is 17 times higher than the chance of a singleton having this dreadful complication.

Answer from: Alessandra Parrella

Embryologist, Andrologist, Embriologist IVF-Spain
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With the “elective single embryo transfer” just one embryo is selected and transferred among different embryos available. The remaining embryos are cryopreserved for future use. The primary goal of the elective single embryo transfer is to decrease the multiple pregnancies. Transferring more than one embryo increases the chances of having multiple pregnancies that is dangerous for the mother and for the babies that are born prematurely.

Answer from: George Koustas, DR

Embryologist, Director of Embryology and Quality Manager Agora Clinic
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Elective single embryo transfer is simply a single embryo that has been selected from a group of embryos that is available to be transferred. Elective single embryo transfer helps women avoid risk to their own health that is associated with multiple pregnancies.

Answer from: Despina Tzanakaki

Senior Embryologist, Director of IVF and Andrology lab at Aretaieio Hospital
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Elective Single Embryo Transfer involves the procedure in which only one embryo is selected to be placed in a woman’s womb from a larger number of available embryos coming from an IVF attempt. Although transferring multiple embryos might maximize pregnancy rates, single embryo transfer seems the safest option when you want to avoid increasing the chance of multiple pregnancy and its associated complications.

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What is eSET ?

We need to keep in mind that different age groups present different statistics and also there are other factors that influence the success rate. We need to bear in mind that the risks associated with twin pregnancy are real and for this reason eSET – elective single embryo transfer is standard.

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